Reading, PA Long-Term Disability (ERISA) Lawyer

When an accident or newly diagnosed illness or medical condition prevents you from working in Reading, our lawyers can help you maximize your financial recovery from your long-term disability insurance policy.

The Employee Retirement Income Security Act exists so that workers can get the employee benefits they are entitled to under their long-term disability plans or other employer-provided policies. Because of ERISA, long-term disability insurance providers must act in the claimant’s best interests and must give full and fair reviews of all claims. When preparing a claim for long-term disability benefits in Reading, our lawyers will review the policy and focus on gathering relevant medical information. Medical records are typically the most important evidence in these claims, along with statements from claimants and their physicians. We will also calculate your likely benefit amount under your policy and explain which damages are recoverable if you file an ERISA appeal after an initial denial in Reading.

To get a free and confidential case review from Young, Marr, Mallis & Associates, call our long-term disability lawyers now at (215) 515-2954.

How ERISA Governs Long-Term Disability Claims in Reading, PA

Employees can often purchase private long-term disability insurance policies through their employers, and ERISA governs these policies to ensure employees receive benefits, should they need them.

While injured workers might be eligible for certain compensation for occupational accidents, injuries, and illnesses, such as Workers’ Compensation or Social Security Disability Insurance, purchasing separate and private long-term disability policies can add another level of protection and an additional avenue for compensation. The Employee Retirement Income Security Act was created to protect employee benefits and prevent mismanagement, fraud, and issues recovering benefits.

ERISA protects employees’ access to long-term disability benefits in various ways, such as placing a fiduciary duty on the insurance company to act in the claimant’s best interests, not the employer’s, according to 29 U.S.C. § 1104(a)(1). ERISA also requires insurance companies to give full and fair reviews of all claims, inform participants of their rights under a policy, and disclose relevant details related to the case. ERISA also provides a pathway for claimants to appeal denied long-term disability insurance claims so that they can get the benefits they deserve.

ERISA does not govern all long-term disability plans, and our lawyers will confirm whether yours is protected by the Employment Retirement Income Security Act when reviewing your case in Reading. If you do not have private long-term disability insurance, our lawyers can review your case to see if there are other viable routes to compensation.

Preparing an ERISA Claim for Long-Term Disability Benefits in Reading, PA

Suppose your claim for long-term disability benefits was denied, and ERISA governs your policy. In that case, our lawyers can confirm if you qualify to file an appeal and guide you through the process in Reading. If you have yet to file your long-term disability claim for benefits, we can help you prepare it to increase its chances of approval the first time.

Review Your Policy

Initially, our lawyers will review your long-term disability insurance policy to determine if ERISA governs it. The policy will give us crucial information on how to proceed with your claim, who to contact, and the policy’s limits. We can help claimants get copies of their policies from plan administrators by making written requests.

Gather Medical Information

Insurers assess long-term disability claims based on the medical information and evidence claimants can provide. Our long-term disability lawyers may get statements from physicians or specialists who have treated you to confirm your condition and inability to work. We can help you obtain medical records from hospitals and providers so that the insurance company appreciates your condition. The more information we can provide, the better, and it should include records of all tests, treatments, prescription medications, and therapies you have received because of your illness, injury, or disability in Reading. Because many providers must follow the rules set by ERISA when administrating policies and reviewing claims, denying claims becomes harder when claimants provide ample medical information.

Suppose your initial claim for benefits was denied, and the insurer violated your rights under ERISA somehow. In that case, our lawyers can help you pursue an appeal, which will require additional medical information. Do not stop getting medical treatment throughout the entire claims process, even after a possible denial. During an appeal, we will need to show that your disability continues to affect your life and earning capacity, which requires updated medical records.

Identify Losses and Calculate Recovery

When reviewing your ERISA policy in Reading, our lawyers will identify all recoverable losses and explain your maximum recovery. Typically, claimants can get compensation for all reasonable medical costs associated with a covered illness, injury, or disability. Suppose an insurer wrongly terminates or denies your medical benefits, and our lawyers file an appeal. In that case, you may recover compensation for medical damages incurred during that time in your ERISA lawsuit.

When employees purchase long-term disability insurance plans in Reading, they do so to protect their incomes in case of a future disabling medical condition. That is to say, claimants expect to get compensation for their lost wages, as that is the primary purpose of getting long-term disability insurance, apart from the compensation for medical damages. When initially filing your claim for long-term disability benefits, our lawyers will assess your lost wages based on employment records, tax returns, and paystubs.

It is important to note that non-economic and punitive damages are not recoverable in ERISA claims, even when victims file lawsuits for wrongly terminated or denied claims in Reading. Because of this, recovering the maximum in economic damages is crucial for those who rely on long-term disability benefits.

Call Our Attorneys About Your Case in Reading, PA Today

Call Young, Marr, Mallis & Associates’ long-term disability lawyers for a free case review at (215) 515-2954.